Anomalous origin of the circumflex coronary artery from the right sinus of Valsalva is the most common coronary anomaly and is usually considered benign. Although several researchers in the past believed that aberrancy predisposes this vessel to accelerated atherosclerosis, this could not get wide acceptance owing to lack of convincing data. To examine the suggestion that atherosclerosis affects the anomalous circumflex artery more severely, the authors reviewed the clinical and angiographic features of patients with this anomaly identified from 2,684 coronary angiography procedures performed between January 1998 and March 2000 at their institution. The degree of atherosclerotic narrowing in the anomalous artery was compared with that in other coronary arteries in the same patient as well as in the nonanomalous circumflex arteries in controls. For comparison 3 control subjects were selected for each patient with anomalous circumflex artery, matched by age, sex, and clinical presentations. The results showed earlier and greater degree of atherosclerotic narrowing of the anomalous artery as compared to the other coronary arteries in the same patients as well as to nonanomalous circumflex arteries of age- and gender-matched control subjects with similar clinical characteristics. However, this predilection for atherosclerosis was evident only in anomalous vessels arising from the right side and pursuing a retroaortic course. The anomalous artery was responsible for myocardial infarction in 3 patients, all of whom were 60 years or older. Two of the patients with this anomaly and myocardial infarction underwent successful angioplasty with stent placement for symptomatic relief.

Background and Objectives: The two most common complications of diabetes mellitus are retinopathy and neuropathy which are dealt by two different medical departments. Early detection and management are therefore necessary to prevent progression of these two diseases and will give a knowledgeable idea regarding the both. Thus, this study was done to know the association of diabetic peripheral neuropathy and diabetic retinopathy. Methods: This was a cross sectional study comprised of 200 cases of type 2 diabetes mellitus selected from the ophthalmology department and referred cases from other departments. A thorough history and examination was done in both departments, that is, complete ophthalmic and neurological examination respectively. Relevant investigations, if needed, were done and diabetic retinopathy was classified according to ETDRS classification. Results: Of the 200 patients having type 2 diabetes for more than 5 years, 28% of cases had diabetic retinopathy and 59% of cases had peripheral neuropathy. Peripheral neuropathy was twice more common than retinopathy. 33.1% had retinopathy and 65.46% had peripheral neuropathy among the uncontrolled diabetics. The prevalence of retinopathy increased 1.3 times in patients with neuropathy (16%) than in patients without peripheral neuropathy (12%). Conclusion: As there was higher incidence of peripheral neuropathy, it is important as ophthalmologists to look for peripheral neuropathy in diabetics which will help in reducing diabetes-related morbidities.

ABSTRACT-Biochemical effects of acute and subacute treatments with ambrein were investigated in rats by measuring the total proteins, cholesterol, triglycerides, GOT, GPT and alkaline phosphatase in the blood plasma. Also, determinations of prothrombin time (PT), partial thrombin time (PTT), thrombin time (TT) and fibrinogen level were performed. Furthermore, changes in plasma electrolyte concentration were studied. Ambrein administered i.p. did not cause any toxic symptoms in the liver as revealed by the histology of the liver tissue both in acute and subacute treatments. Ambrein itself did not significantly affect the plasma protein, cholesterol, GOT and GPT profiles, but lowered alkaline phosphatase at high doses (50 and 250 mg/kg) after subacute treatment. Thus far, no specific pattern of action of ambrein in electrolyte control has been found. However, it increased PT, PTT and TT and decreased fibrinogen levels in both the acute and subacute studies, pointing towards its potential as an anticoagulant and antifibrinogenic agent.

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A Jamjoom, Naim-Ur-Rahman, MA Hafeez, ZA Jamjoom, Clival Chordoma in Childhood: A Report of Two Cases. 1993; 13(3): 280-282 Cranial chordomas are rare neoplasms accounting for less than 0.5% of all intracranial tumors [1]. Although they are presumed to arise from remnants of the primitive notochord, it is rare for these tumors to present in childhood. Up to date, only around 37 cases of cranial chordomas in children 16 years and younger [2] have been reported in the literature, while the tumor was reported to occur in children less than five years of age in 11 of these cases only [3]. Considering the worldwide rarity of this pathology in children, we were surprised to find two cases with clival chordomas among the 62 cases of childhood brain tumors treated in our unit. We are unaware of any reports of clival chordomas in children in Saudi Arabia and therefore feel justified in reporting our two cases to emphasize the rarity of this pathology in the pediatric age group and heighten awareness of clinicians about clival chordomas which may prove to be not such a rare tumor in our region. Case ReportsBetween 1984-1991, two children with clival chordomas were treated at King Khalid University Hospital. The clinical data for the cases are summarized in the Table. The diagnosis was made by CT scan which showed a tumor destroying the clivus and petrous bones and invading the sella, sphenoid sinus, and nasopharynx in Case 1 (Figure 1) and a tumor destroying the clivus and extending posteriorly into the cerebellum and displacing the brainstem to the left in Case 2 (Figure 2). The histological diagnosis was undisputed for both cases. The tumor was composed of loosely attached cells arranged in sheets, cords, or lobules ( Figure 3A) and the characteristic multivacuolated or "physaliphorous" cell with its ample vacuolated cytoplasm was evident ( Figure 3B).